Search results for: quality of experience (QoE)
9079 Influence of Reinforcement Stiffness on the Performance of Back-to-Back Reinforced Earth Wall upon Rainwater Infiltration
Authors: Gopika Rajagopal, Sudheesh Thiyyakkandi
Abstract:
Back-to-back reinforced earth (RE) walls are extensively used in these days as bridge abutments and highway ramps, owing to their cost efficiency and ease of construction. High quality select fill is the most suitable backfill material due to its excellent engineering properties and constructability. However, industries are compelled to use low quality, locally available soil because of its ample availability on site. However, several failure cases of such walls are reported, especially subsequent to rainfall events. The stiffness of reinforcement is one of the major factors affecting the performance of RE walls. The present study focused on analyzing the effect of reinforcement stiffness on the performance of complete select fill, complete marginal fill, and hybrid-fill (i.e., combination of select and marginal fills) back-to-back RE walls, immediately after construction and upon rainwater infiltration through finite element modelling. A constant width to height (W/H) ratio of 3 and height (H) of 6 m was considered for the numerical analysis and the stiffness of reinforcement layers was varied from 500 kN/m to 10000 kN/m. Results showed that reinforcement stiffness had a noticeable influence on the response of RE wall, subsequent to construction as well as rainwater infiltration. Facing displacement was found to decrease and maximum reinforcement tension and factor of safety were observed to increase with increasing the stiffness of reinforcement. However, beyond a stiffness of 5000 kN/m, no significant reduction in facing displacement was observed. The behavior of fully marginal fill wall considered in this study was found to be reasonable even after rainwater infiltration when the high stiffness reinforcement layers are used.Keywords: back-to-back reinforced earth wall, finite element modelling, rainwater infiltration, reinforcement stiffness
Procedia PDF Downloads 1579078 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital
Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah
Abstract:
Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.Keywords: ambulance offload, district general hospital, handover, quality improvement
Procedia PDF Downloads 1099077 Determinants of Rural Household Effective Demand for Biogas Technology in Southern Ethiopia
Authors: Mesfin Nigussie
Abstract:
The objectives of the study were to identify factors affecting rural households’ willingness to install biogas plant and amount willingness to pay in order to examine determinants of effective demand for biogas technology. A multistage sampling technique was employed to select 120 respondents for the study. The binary probit regression model was employed to identify factors affecting rural households’ decision to install biogas technology. The probit model result revealed that household size, total household income, access to extension services related to biogas, access to credit service, proximity to water sources, perception of households about the quality of biogas, perception index about attributes of biogas, perception of households about installation cost of biogas and availability of energy source were statistically significant in determining household’s decision to install biogas. Tobit model was employed to examine determinants of rural household’s amount of willingness to pay. Based on the model result, age of the household head, total annual income of the household, access to extension service and availability of other energy source were significant variables that influence willingness to pay. Providing due considerations for extension services, availability of credit or subsidy, improving the quality of biogas technology design and minimizing cost of installation by using locally available materials are the main suggestions of this research that help to create effective demand for biogas technology.Keywords: biogas technology, effective demand, probit model, tobit model, willingnes to pay
Procedia PDF Downloads 1449076 Bivariate Time-to-Event Analysis with Copula-Based Cox Regression
Authors: Duhania O. Mahara, Santi W. Purnami, Aulia N. Fitria, Merissa N. Z. Wirontono, Revina Musfiroh, Shofi Andari, Sagiran Sagiran, Estiana Khoirunnisa, Wahyudi Widada
Abstract:
For assessing interventions in numerous disease areas, the use of multiple time-to-event outcomes is common. An individual might experience two different events called bivariate time-to-event data, the events may be correlated because it come from the same subject and also influenced by individual characteristics. The bivariate time-to-event case can be applied by copula-based bivariate Cox survival model, using the Clayton and Frank copulas to analyze the dependence structure of each event and also the covariates effect. By applying this method to modeling the recurrent event infection of hemodialysis insertion on chronic kidney disease (CKD) patients, from the AIC and BIC values we find that the Clayton copula model was the best model with Kendall’s Tau is (τ=0,02).Keywords: bivariate cox, bivariate event, copula function, survival copula
Procedia PDF Downloads 869075 Machinability Analysis in Drilling Flax Fiber-Reinforced Polylactic Acid Bio-Composite Laminates
Authors: Amirhossein Lotfi, Huaizhong Li, Dzung Viet Dao
Abstract:
Interest in natural fiber-reinforced composites (NFRC) is progressively growing both in terms of academia research and industrial applications thanks to their abundant advantages such as low cost, biodegradability, eco-friendly nature and relatively good mechanical properties. However, their widespread use is still presumed as challenging because of the specificity of their non-homogeneous structure, limited knowledge on their machinability characteristics and parameter settings, to avoid defects associated with the machining process. The present work is aimed to investigate the effect of the cutting tool geometry and material on the drilling-induced delamination, thrust force and hole quality produced when drilling a fully biodegradable flax/poly (lactic acid) composite laminate. Three drills with different geometries and material were used at different drilling conditions to evaluate the machinability of the fabricated composites. The experimental results indicated that the choice of cutting tool, in terms of material and geometry, has a noticeable influence on the cutting thrust force and subsequently drilling-induced damages. The lower value of thrust force and better hole quality was observed using high-speed steel (HSS) drill, whereas Carbide drill (with point angle of 130o) resulted in the highest value of thrust force. Carbide drill presented higher wear resistance and stability in variation of thrust force with a number of holes drilled, while HSS drill showed the lower value of thrust force during the drilling process. Finally, within the selected cutting range, the delamination damage increased noticeably with feed rate and moderately with spindle speed.Keywords: natural fiber reinforced composites, delamination, thrust force, machinability
Procedia PDF Downloads 1329074 Agronomic Evaluation of Flax Cultivars (Linum Usitatissimum L.) in Response to Irrigation Intervals
Authors: Emad Rashwan, M. Mousa, Ayman EL Sabagh, Celaleddin Barutcular
Abstract:
Flax is a potential winter crop for Egypt that can be grown for both seed and fiber. The study was conducted during two successive winter seasons of 2013/2014, and 2014/2015 in the experimental farm of El-Gemmeiza Agricultural Research Station, Agriculture research Centre, Egypt. The objective of this work was to evaluate the effect of irrigation intervals (25, 35 and 45) on the seed yield and quality of flax cultivars (Sakha1, Giza9 and Giza10). Obtained results indicate that highly significant for all studied traits among irrigation intervals except oil percentage that was not significant in both seasons. Irrigated flax plants every 35 days gave the maximum values for all characters. In contrast, irrigation every 45 days gave the minimum values for all studied characters under this study. In respect to cultivars, significant differences in most yield and quality characters were found. Furthermore, the performance of Sakha1 cultivar was superior in total plant height, main stem diameter, seed index, seed, oil, biological and straw yield /ha as well as fiber length and fiber fineness. Meanwhile, Giza9 and Giza10 cultivars were surpassed in fiber yield/hand fiber percentage, respectively. The interactions between irrigation intervals and flax cultivars were highly significant for total plant height, main stem diameter, seed, oil, biological and straw yields /ha. Based on the results, all flax cultivars recorded the maximum values for major traits were measured under irrigation of flax plants every 35 days.Keywords: flax, fiber, irrigation intervals, oil, seed yield
Procedia PDF Downloads 2559073 The Misuse of Free Cash and Earnings Management: An Analysis of the Extent to Which Board Tenure Mitigates Earnings Management
Authors: Michael McCann
Abstract:
Managerial theories propose that, in joint stock companies, executives may be tempted to waste excess free cash on unprofitable projects to keep control of resources. In order to conceal their projects' poor performance, they may seek to engage in earnings management. On the one hand, managers may manipulate earnings upwards in order to post ‘good’ performances and safeguard their position. On the other, since managers pursuit of unrewarding investments are likely to lead to low long-term profitability, managers will use negative accruals to reduce current year’s earnings, smoothing earnings over time in order to conceal the negative effects. Agency models argue that boards of directors are delegated by shareholders to ensure that companies are governed properly. Part of that responsibility is ensuring the reliability of financial information. Analyses of the impact of board characteristics, particularly board independence on the misuse of free cash flow and earnings management finds conflicting evidence. However, existing characterizations of board independence do not account for such directors gaining firm-specific knowledge over time, influencing their monitoring ability. Further, there is little analysis of the influence of the relative experience of independent directors and executives on decisions surrounding the use of free cash. This paper contributes to this literature regarding the heterogeneous characteristics of boards by investigating the influence of independent director tenure on earnings management and the relative tenures of independent directors and Chief Executives. A balanced panel dataset comprising 51 companies across 11 annual periods from 2005 to 2015 is used for the analysis. In each annual period, firms were classified as conducting earnings management if they had discretionary accruals in the bottom quartile (downwards) and top quartile (upwards) of the distributed values for the sample. Logistical regressions were conducted to determine the marginal impact of independent board tenure and a number of control variables on the probability of conducting earnings management. The findings indicate that both absolute and relative measures of board independence and experience do not have a significant impact on the likelihood of earnings management. It is the level of free cash flow which is the major influence on the probability of earnings management. Higher free cash flow increases the probability of earnings management significantly. The research also investigates whether board monitoring of earnings management is contingent on the level of free cash flow. However, the results suggest that board monitoring is not amplified when free cash flow is higher. This suggests that the extent of earnings management in companies is determined by a range of company, industry and situation-specific factors.Keywords: corporate governance, boards of directors, agency theory, earnings management
Procedia PDF Downloads 2389072 Computing Machinery and Legal Intelligence: Towards a Reflexive Model for Computer Automated Decision Support in Public Administration
Authors: Jacob Livingston Slosser, Naja Holten Moller, Thomas Troels Hildebrandt, Henrik Palmer Olsen
Abstract:
In this paper, we propose a model for human-AI interaction in public administration that involves legal decision-making. Inspired by Alan Turing’s test for machine intelligence, we propose a way of institutionalizing a continuous working relationship between man and machine that aims at ensuring both good legal quality and higher efficiency in decision-making processes in public administration. We also suggest that our model enhances the legitimacy of using AI in public legal decision-making. We suggest that case loads in public administration could be divided between a manual and an automated decision track. The automated decision track will be an algorithmic recommender system trained on former cases. To avoid unwanted feedback loops and biases, part of the case load will be dealt with by both a human case worker and the automated recommender system. In those cases an experienced human case worker will have the role of an evaluator, choosing between the two decisions. This model will ensure that the algorithmic recommender system is not compromising the quality of the legal decision making in the institution. It also enhances the legitimacy of using algorithmic decision support because it provides justification for its use by being seen as superior to human decisions when the algorithmic recommendations are preferred by experienced case workers. The paper outlines in some detail the process through which such a model could be implemented. It also addresses the important issue that legal decision making is subject to legislative and judicial changes and that legal interpretation is context sensitive. Both of these issues requires continuous supervision and adjustments to algorithmic recommender systems when used for legal decision making purposes.Keywords: administrative law, algorithmic decision-making, decision support, public law
Procedia PDF Downloads 2229071 Utilization of Extracted Spirogyra sp. Media Fermented by Gluconacetobacter Xylinum for Cellulose Production as Raw Material for Paper Product
Authors: T. S. Desak Ketut, A.n. Isna, A.a. Ayu, D. P. Ririn, Suharjono Hadiatullah
Abstract:
The requirement of paper from year to year rise rapidly. The raising of cellulose requirement in paper production caused increasing of wood requirement with the effect that limited forest areal because of deforestation. Alternative cellulose that can be used for making paper is microbial cellulose. The objective of this research are to know the effectivity fermentation media Spirogyra sp. by Gluconacetobacter xylinum for cellulose production as material for the making of paper and to know effect composition bacterial cellulose composite product of Gluconacetobacter xylinum in Spirogyra sp. The method, was used, is as follow, 1) the effect assay from variation composition of fermentation media to bacterial cellulose production by Gluconacetobacter xylinum. 2) The effect assay of composition bacterial cellulose fermentation producted by Gluconacetobacter xylinum in extracted Spirogyra media to paper quality. The result of this research is variation fermentation media Spirogyra sp. affect to production of cellulose by Gluconacetobacter xylinum. Thus, result showed by the highest value and significantly different in thickness parameter, dry weight and wet weight of nata in sucrose concentration 7,5 % and urea 0,75 %. Composition composite of bacterial cellulose from fermentation product by Gluconacetobacter xylinum in media Spirogyra sp. affect to paper quality from wet nata and dry nata. Parameters thickness, weight, water absorpsion, density and gramatur showed highest result in sucrose concentration 7,5 % and urea concentration 0,75 %, except paper density from dry nata had highest result in sucrose and urea concentration 0%.Keywords: cellulose, fermentation media, , Gluconacetobacter xylinum, paper, Spirogyra sp.
Procedia PDF Downloads 3479070 The Study of Self-Care Regarding to the Valuable Living in Thai Elderly
Authors: Pannathorn Chachvarat, Smarnjit Piromrun
Abstract:
Aging is the reality for the future world. An urgent priority for the development of the elderlies’ quality living is needed. The promotion of quality the elderly to live longer in their dignity and being independence are essential. The objective of this descriptive research was to study the self-care regarding to the valuable living in Thai elderly. The randomized sample was 100 elderly who live in Muang district of Phayao province. The tools included 2 parts; 1) Personal data (gender, age, income, occupation, marital status, living condition and disease), and 2) the self-care regarding to the valuable living questionnaire consisted of 3 domains, physical (21items), spiritual (13 items) and social domain (12 items). The content validity tool was tested the IOC ranged between 0.60 – 1.00 and the reliability test, Cronbach Alpha was 0.82. The research found that; The most participants were female (60 %), Farmer (37%), and underlying disease (65 %). The range of age was 68 years. Overall of the self-care regarding to the valuable living of physical, spiritual and social were at the high level.The highest level of physical activities was self-taking bath twice a day (morning and evening), and slept at least 5-6 hours at night time.The highest level of spirit activities was a good member of the family, contributions to persons in family, good emotion. Additionally were enjoyable, accepting changes in the body such as the dry skin and the blurred vision, accepting the roles and duties in taking care of house and grandchildren, selecting the applicable activities and practice according to religious Buddhateachingfor the happiness and meditated life.The highest of the social activities were the good relationship between other elderlies and family members, happy to help social activities as of their capacity, and being happy to help other people who have problems.Keywords: self-care, valuable living, elderly, Thai
Procedia PDF Downloads 2909069 The Effect of Flow Discharge on Suspended Solids Transport in the Nakhon-Nayok River
Authors: Apichote Urantinon
Abstract:
Suspended solid is one factor for water quality in open channel. It affects various problems in waterways that could cause high sedimentation in the channels, leading to shallowness in the river. It is composed of the organic and inorganic materials which can settle down anywhere along the open channel. Thus, depends on the solid amount and its composition, it occupies the water body capacity and causes the water quality problems simultaneously. However, the existing of suspended solid in the water column depends on the flow discharge (Q) and secchi depth (sec). This study aims to examine the effect of flow discharge (Q) and secchi depth (sec) on the suspended solids concentration in open channel and attempts to establish the formula that represents the relationship between flow discharges (Q), secchi depth (sec) and suspended solid concentration. The field samplings have been conducted in the Nakhon-Nayok river, during the wet season, September 15-16, 2014 and dry season, March 10-11, 2015. The samplings with five different locations are measured. The discharge has been measured onsite by floating technics, the secchi depth has been measured by secchi disc and the water samples have been collected at the center of the water column. They have been analyzed in the laboratory for the suspended solids concentration. The results demonstrate that the decrease in suspended solids concentration is dependent on flow discharge, since the natural processes in erosion consists of routing of eroded material. Finally, an empirical equation to compute the suspended solids concentration that shows an equation (SScon = 9.852 (sec)-0.759 Q0.0355) is developed. The calculated suspended solids concentration, with uses of empirical formula, show good agreement with the record data as the R2 = 0.831. Therefore, the empirical formula in this study is clearly verified.Keywords: suspended solids concentration, the Nakhon-Nayok river, secchi depth, floating technics
Procedia PDF Downloads 2529068 Trauma-Informed Leadership: Educational Leadership Practices in a Global Pandemic
Authors: Kyna Elliott
Abstract:
The COVID-19 global pandemic has changed the shape, design, and delivery of education. As communities continue to fight the pandemic, research suggests the coronavirus is leaving an indelible mark on education which will last long after the pandemic has ended. Faculty and students bring more than their textbooks into the classroom. They bring their lived experiences into the classroom, and it is through these lived experiences that interactions and learning filter through. The COVID-19 pandemic has proved to be a traumatic experience for many. Leaders will need to have the tools and skills to mitigate trauma's impact on faculty and students. This presentation will explore research-based trauma-informed leadership practices, pedagogy, and mitigation strategies within secondary school environments.Keywords: COVID-19, compassion fatigue, educational leadership, the science of trauma, trauma-informed leadership, trauma-informed pedagogy
Procedia PDF Downloads 2239067 Assessing the Nutritional Characteristics and Habitat Modeling of the Comorian’s Yam (Dioscorea comorensis) in a Fragmented Landscape
Authors: Mounir Soule, Hindatou Saidou, Razafimahefa, Mohamed Thani Ibouroi
Abstract:
High levels of habitat fragmentation and loss are the main drivers of plant species extinction. They reduce the habitat quality, which is a determining factor for the reproduction of plant species, and generate strong selective pressures for habitat selection, with impacts on the reproduction and survival of individuals. The Comorian’s yam (Dioscorea comorensis) is one of the most threatened plant species of the Comoros archipelago. The species faces one of the highest rates of habitat loss worldwide (9.3 % per year) and is classified as Endangered in the IUCN red list. Despite the nutritional potential of this tuber, the Comorian’s yam cultivation remains neglected by local populations due probably to lack of knowledge on its nutritional importance and the factors driving its spatial distribution and development. In this study, we assessed the nutritional characteristics of Dioscorea comorensis and the drivers of spatial distribution and abundance to propose conservation measures and improve crop yields. To determine the nutritional characteristics, the Kjeldahl method, the Soxhlet method, and Atwater's specific calorific coefficients methods were applied for analyzing proteins, lipids, and caloric energy respectively. In addition, atomic absorption spectrometry was used to measure mineral particles. By combining species occurrences with ecological (habitat types), climatic (temperature, rainfall, etc.), and physicochemical (soil types and quality) variables, we assessed habitat suitability and spatial distribution of the species and the factors explaining the origin, persistence, distribution and competitive capacity of a species using a Species Distribution Modeling (SDM) method. The results showed that the species contains 83.37% carbohydrates, 6.37% protein, and 0.45% lipids. In 100 grams, the quantities of Calcium, Sodium, Zinc, Iron, Copper, Potassium, Phosphorus, Magnesium, and Manganese are respectively 422.70, 599.41, 223.11, 252.32, 332.20, 780.41, 444.17, 287.71 and 220.73 mg. Its PRAL index is negative (- 9.80 mEq/100 g), and its Ca/P (0.95) and Na/K (0.77) ratios are less than 1. This species provides an energy value of 357.46 Kcal per 100 g, thanks to its carbohydrates and minerals and is distinguished from others by its high protein content, offering benefits for cardiovascular health. According to our SDM, the species has a very limited distribution, restricted to forests with higher biomass, humidity, and clay. Our findings highlight how distribution patterns are related to ecological and environmental factors. They also emphasize how the Comoros yam is beneficial in terms of nutritional quality. Our results represent a basic knowledge that will help scientists and decision-makers to develop conservation strategies and to improve crop yields.Keywords: Dioscorea comorensis, nutritional characteristics, species distribution modeling, conservation strategies, crop yields improvement
Procedia PDF Downloads 439066 Adaptation in Translation of 'Christmas Every Day' Short Story by William Dean Howells
Authors: Mohsine Khazrouni
Abstract:
The present study is an attempt to highlight the importance of adaptation in translation. To convey the message, the translator needs to take into account not only the text but also extra-linguistic factors such as the target audience. The present paper claims that adaptation is an unavoidable translation strategy when dealing with texts that are heavy with religious and cultural themes. The translation task becomes even more challenging when dealing with children’s literature as the audience are children whose comprehension, experience and world knowledge are limited. The study uses the Arabic translation of the short story ‘Christmas Every Day’ as a case study. The short story will be translated, and the pragmatic problems involved will be discussed. The focus will be on the issue of adaptation. i.e., the source text should be adapted to the target language audience`s social and cultural environment.Keywords: pragmatic adaptation, Arabic translation, children's literature, equivalence
Procedia PDF Downloads 2189065 Bench-scale Evaluation of Alternative-to-Chlorination Disinfection Technologies for the Treatment of the Maltese Tap-water
Authors: Georgios Psakis, Imren Rahbay, David Spiteri, Jeanice Mallia, Martin Polidano, Vasilis P. Valdramidis
Abstract:
Absence of surface water and progressive groundwater quality deterioration have exacerbated scarcity rapidly, making the Mediterranean island of Malta one of the most water-stressed countries in Europe. Water scarcity challenges have been addressed by reverse osmosis desalination of seawater, 60% of which is blended with groundwater to form the current potable tap-water supply. Chlorination has been the adopted method of water disinfection prior to distribution. However, with the Malteseconsumer chlorine sensory-threshold being as low as 0.34 ppm, presence of chorine residuals and chlorination by-products in the distributed tap-water impacts negatively on its organoleptic attributes, deterring the public from consuming it. As part of the PURILMA initiative, and with the aim of minimizing the impact of chlorine residual on the quality of the distributed water, UV-C, and hydrosonication, have been identified as cost- and energy-effective decontamination alternatives, paving the way for more sustainable water management. Bench-scale assessment of the decontamination efficiency of UV-C (254 nm), revealed 4.7-Log10 inactivation for both Escherichia coli and Enterococcus faecalis at 36 mJ/cm2. At >200 mJ/cm2fluence rates, there was a systematic 2-Log10 difference in the reductions exhibited by E. coli and E. faecalis to suggest that UV-C disinfection was more effective against E. coli. Hybrid treatment schemes involving hydrosonication(at 9.5 and 12.5 dm3/min flow rates with 1-5 MPa maximum pressure) and UV-C showed at least 1.1-fold greater bactericidal activity relative to the individualized UV-C treatments. The observed inactivation appeared to have stemmed from additive effects of the combined treatments, with hydrosonication-generated reactive oxygen species enhancing the biocidal activity of UV-C.Keywords: disinfection, groundwater, hydrosonication, UV-C
Procedia PDF Downloads 1779064 Impact of Primary Care Telemedicine Consultations On Health Care Resource Utilisation: A Systematic Review
Authors: Anastasia Constantinou, Stephen Morris
Abstract:
Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare
Procedia PDF Downloads 629063 Muslims as the Cultural ‘Other’ in Europe and the Crisis of Multiculturalism
Authors: Tatia Tavkhelidze
Abstract:
The European agenda on multiculturalism has undermined Muslim communities through cultural repulsion. Muslims have been labeled as primitive and dangerous people. They experience discrimination at university, workplace, or in the public sphere on a daily basis. Keeping this in view, the proposed research argues that the coining of Muslimness as a problem in modern European societies indicates the crisis of multiculturalism and it could be explained by the anthropological theory of cultural othering. To prove this assumption, the research undertakes a content analysis of modern policy discourse about Muslims and Islam in different European countries (e.g. France, Austria, Denmark, and Hungary). It focuses on the speech of populist politicians, right-wing party leaders and state officials. The research findings are of great significance as they elucidate that the European societies forgot to respect their own values of toleration, religious liberty and democracy; and undermine the European motto 'unity in diversity.Keywords: assimilation, islamophobia, multiculturalism, populism
Procedia PDF Downloads 2099062 Integer Programming: Domain Transformation in Nurse Scheduling Problem.
Authors: Geetha Baskaran, Andrzej Barjiela, Rong Qu
Abstract:
Motivation: Nurse scheduling is a complex combinatorial optimization problem. It is also known as NP-hard. It needs an efficient re-scheduling to minimize some trade-off of the measures of violation by reducing selected constraints to soft constraints with measurements of their violations. Problem Statement: In this paper, we extend our novel approach to solve the nurse scheduling problem by transforming it through Information Granulation. Approach: This approach satisfies the rules of a typical hospital environment based on a standard benchmark problem. Generating good work schedules has a great influence on nurses' working conditions which are strongly related to the level of a quality health care. Domain transformation that combines the strengths of operation research and artificial intelligence was proposed for the solution of the problem. Compared to conventional methods, our approach involves judicious grouping (information granulation) of shifts types’ that transforms the original problem into a smaller solution domain. Later these schedules from the smaller problem domain are converted back into the original problem domain by taking into account the constraints that could not be represented in the smaller domain. An Integer Programming (IP) package is used to solve the transformed scheduling problem by expending the branch and bound algorithm. We have used the GNU Octave for Windows to solve this problem. Results: The scheduling problem has been solved in the proposed formalism resulting in a high quality schedule. Conclusion: Domain transformation represents departure from a conventional one-shift-at-a-time scheduling approach. It offers an advantage of efficient and easily understandable solutions as well as offering deterministic reproducibility of the results. We note, however, that it does not guarantee the global optimum.Keywords: domain transformation, nurse scheduling, information granulation, artificial intelligence, simulation
Procedia PDF Downloads 3999061 The Social Perception of National Security Risks: A Comparative Perspective
Authors: Nicula Valentin, Andrei Virginia
Abstract:
Nowadays, the individual plays a central role in the state’s architecture. This is why the subjective dimension of the security represents a key concept in risk assessment. The paper’s scope is to emphasize the discrepancy between expert and lay evaluations of national security hazards, which is caused by key factors like emotions, personal experience, knowledge and media. Therefore, we have chosen to apply, using these two different groups of respondents, the Q-sort method, which reveals individual beliefs, attitudes, preferences hidden behind the subjects’ own way of prioritizing the risks they are confronted with. Our study’s conclusions are meant to unveil significant indicators needed to be taken into consideration by a state’s leadership in order to understand the social perception of national security hazards, to communicate better with the public opinion and prevent or mitigate the overestimation of the severity or probability of these dangers.Keywords: risk perception, Q-sort method, national security hazards, individual beliefs
Procedia PDF Downloads 3159060 Living the Religious of the Virgin Mary (RVM) Educational Mission: A Grounded Theory Approach
Authors: Violeta Juanico
Abstract:
While there was a statement made by the RVM Education Ministry Commission that its strength is its Ignacian identity, shaped by the Ignacian spirituality that permeates the school community leading to a more defined RVM school culture, there has been no empirical study made in terms of a clear and convincing conceptual framework on how the RVM Educational mission is lived in the Religious of the Virgin Mary (RVM) learning institutions to the best of author’s knowledge. This dissertation is an attempt to come up with a substantive theory that supports and explains the stakeholders’ experiences with the RVM educational mission in the Philippines. Participants that represent the different stakeholders ranging from students to administrators were interviewed. The expressions and thoughts of the participants were initially coded and analyzed using the Barney Glaser’s original grounded theory methodology to find out how the RVM mission is lived in the field of education.Keywords: catholic education, grounded theory, lived experience, RVM educational mission
Procedia PDF Downloads 4739059 Reinforcement-Learning Based Handover Optimization for Cellular Unmanned Aerial Vehicles Connectivity
Authors: Mahmoud Almasri, Xavier Marjou, Fanny Parzysz
Abstract:
The demand for services provided by Unmanned Aerial Vehicles (UAVs) is increasing pervasively across several sectors including potential public safety, economic, and delivery services. As the number of applications using UAVs grows rapidly, more and more powerful, quality of service, and power efficient computing units are necessary. Recently, cellular technology draws more attention to connectivity that can ensure reliable and flexible communications services for UAVs. In cellular technology, flying with a high speed and altitude is subject to several key challenges, such as frequent handovers (HOs), high interference levels, connectivity coverage holes, etc. Additional HOs may lead to “ping-pong” between the UAVs and the serving cells resulting in a decrease of the quality of service and energy consumption. In order to optimize the number of HOs, we develop in this paper a Q-learning-based algorithm. While existing works focus on adjusting the number of HOs in a static network topology, we take into account the impact of cells deployment for three different simulation scenarios (Rural, Semi-rural and Urban areas). We also consider the impact of the decision distance, where the drone has the choice to make a switching decision on the number of HOs. Our results show that a Q-learning-based algorithm allows to significantly reduce the average number of HOs compared to a baseline case where the drone always selects the cell with the highest received signal. Moreover, we also propose which hyper-parameters have the largest impact on the number of HOs in the three tested environments, i.e. Rural, Semi-rural, or Urban.Keywords: drones connectivity, reinforcement learning, handovers optimization, decision distance
Procedia PDF Downloads 1169058 Teacher Characteristics That Influence Development of Oral Language Skills among Pre-Primary School Pupils: Case Study of Nairobi City County, Kenya
Authors: Kenneth Okelo, Esther Waithaka, Maureen Mweru
Abstract:
Development of oral language skills is a precursor to writing and reading acquisition. Oral skill is a means of communication through which people express their desires, ideas, excitements, amusements, disappointments and exchange information. In addition, oral skills have been found to be an important tool for thinking and concept development in children. Research carried out in industrialised countries have identified some appropriate teaching strategies used to enhance acquisition of oral language skills such as repetition, substitution, explanation, contrast, exemplification and code-switching. However, these studies’ geographical locations do not reflect the diversity of the Kenyan society. In addition, studies conducted in Kenya in the past have not established why pre-primary school teachers are not using appropriate teaching strategies. The purpose of this study was to find out whether teachers’ experience, academic qualification and type of training influences their choice of teaching strategies in the development of oral language skills inside and out of the classroom in selected preschools in Kibra Sub-County, Nairobi County. In addition, this study aimed at finding out the strategies used by teachers in Kibra Sub-County to promote oral skills development among pre-primary school children. The study was guided by Holdaway’s theory of language acquisition. Descriptive survey design was employed during this study. Questionnaires and observation schedules were used to collect data. Eighty-three (83) preschool teachers were sampled using multistage sampling methods for observation. Data was analysed using SPSS version 20. The researcher carried out content analysis on the qualitative data. The main descriptive methods used were tabulation of frequencies and percentages. Chi squire test was the inferential statistic used to test the relationship between variables. The main findings of the study indicate that teaching strategies that were mostly used by pre-primary school teachers were code-switching, examples, repetition, substitution and explanation. While questions, direction, expansion of children words and contrast were the least used teaching strategies when teaching oral language skills. The study revealed that the there is a slight correlation between the type of training of teachers and the teaching strategies as most of DICECE trained teachers used more teaching strategies when teaching oral skills compared to other teachers. The findings also revealed that there was a partial significant correlation between teacher’s academic qualifications and a few teaching strategies. A similar correlation was also observed between teaching experience and a few teaching strategies. Since the strategies used by pre-primary school teachers under the study were less than half of the recommended teaching strategies to promote oral skills, the study recommends that teachers should be encouraged to use more in structural strategies to improve children’s oral language skills.Keywords: Kenya early childhood education, Kenya education, oral language skills acquisition, teaching methods
Procedia PDF Downloads 2689057 CO₂ Recovery from Biogas and Successful Upgrading to Food-Grade Quality: A Case Study
Authors: Elisa Esposito, Johannes C. Jansen, Loredana Dellamuzia, Ugo Moretti, Lidietta Giorno
Abstract:
The reduction of CO₂ emission into the atmosphere as a result of human activity is one of the most important environmental challenges to face in the next decennia. Emission of CO₂, related to the use of fossil fuels, is believed to be one of the main causes of global warming and climate change. In this scenario, the production of biomethane from organic waste, as a renewable energy source, is one of the most promising strategies to reduce fossil fuel consumption and greenhouse gas emission. Unfortunately, biogas upgrading still produces the greenhouse gas CO₂ as a waste product. Therefore, this work presents a case study on biogas upgrading, aimed at the simultaneous purification of methane and CO₂ via different steps, including CO₂/methane separation by polymeric membranes. The original objective of the project was the biogas upgrading to distribution grid quality methane, but the innovative aspect of this case study is the further purification of the captured CO₂, transforming it from a useless by-product to a pure gas with food-grade quality, suitable for commercial application in the food and beverage industry. The study was performed on a pilot plant constructed by Tecno Project Industriale Srl (TPI) Italy. This is a model of one of the largest biogas production and purification plants. The full-scale anaerobic digestion plant (Montello Spa, North Italy), has a digestive capacity of 400.000 ton of biomass/year and can treat 6.250 m3/hour of biogas from FORSU (organic fraction of solid urban waste). The entire upgrading process consists of a number of purifications steps: 1. Dehydration of the raw biogas by condensation. 2. Removal of trace impurities such as H₂S via absorption. 3.Separation of CO₂ and methane via a membrane separation process. 4. Removal of trace impurities from CO₂. The gas separation with polymeric membranes guarantees complete simultaneous removal of microorganisms. The chemical purity of the different process streams was analysed by a certified laboratory and was compared with the guidelines of the European Industrial Gases Association and the International Society of Beverage Technologists (EIGA/ISBT) for CO₂ used in the food industry. The microbiological purity was compared with the limit values defined in the European Collaborative Action. With a purity of 96-99 vol%, the purified methane respects the legal requirements for the household network. At the same time, the CO₂ reaches a purity of > 98.1% before, and 99.9% after the final distillation process. According to the EIGA/ISBT guidelines, the CO₂ proves to be chemically and microbiologically sufficiently pure to be suitable for food-grade applications.Keywords: biogas, CO₂ separation, CO2 utilization, CO₂ food grade
Procedia PDF Downloads 2139056 Transition From Economic Growth-Energy Use to Green Growth-Green Energy Towards Environmental Quality: Evidence from Africa Using Econometric Approaches
Authors: Jackson Niyongabo
Abstract:
This study addresses a notable gap in the existing literature on the relationship between energy consumption, economic growth, and CO₂ emissions, particularly within the African context. While numerous studies have explored these dynamics globally and regionally across various development levels, few have delved into the nuances of regions and income levels specific to African countries. Furthermore, the evaluation of the interplay between green growth policies, green energy technologies, and their impact on environmental quality has been underexplored. This research aims to fill these gaps by conducting a comprehensive analysis of the transition from conventional economic growth and energy consumption to a paradigm of green growth coupled with green energy utilization across the African continent from 1980 to 2018. The study is structured into three main parts: an empirical examination of the long-term effects of energy intensity, renewable energy consumption, and economic growth on CO₂ emissions across diverse African regions and income levels; an estimation of the long-term impact of green growth and green energy use on CO₂ emissions for countries implementing green policies within Africa, as well as at regional and global levels; and a comparative analysis of the impact of green growth policies on environmental degradation before and after implementation. Employing advanced econometric methods and panel estimators, the study utilizes a testing framework, panel unit tests, and various estimators to derive meaningful insights. The anticipated results and conclusions will be elucidated through causality tests, impulse response, and variance decomposition analyses, contributing valuable knowledge to the discourse on sustainable development in the African context.Keywords: economic growth, green growth, energy consumption, CO₂ emissions, econometric models, green energy
Procedia PDF Downloads 639055 Development Contradictions and Planning Methods of Bicycles in Mountainous Cities: A Case Study of Chongqing
Authors: Chuhan Zhang
Abstract:
As a typical mountainous city in the world, with the rise of shared transportation, cycling behavior in Chongqing is undergoing a role change from a traditional leisure activity to an important transportation mode. However, with the rapid increase in people's cycling demand, the built environment with mountainous features in Chongqing has become a key constraint hindering the further development of bicycle traffic. Based on the above background, the research summarizes the current development contradictions of bicycle traffic in Chongqing, analyses the global experience in the construction of bicycle-friendly cities with mountain characteristics, and combines the characteristics of bicycle traffic in Chongqing to further propose the planning method of the bicycle in mountain cities, to improve the bikability of Chongqing from the perspective of urban planning.Keywords: bicycle traffic, mountainous city, bicycle-friendly, bikability, Chongqing
Procedia PDF Downloads 1049054 Jung GPT: Unveiling the Therapeutic Potential of Artificial Intelligence
Authors: Eman Alhajjar, Albatool Jamjoom, Fatmah Bugshan
Abstract:
This research aims to investigate the artificial intelligence (AI) application Jung GPT and how helpful it is, as a therapy AI, to users. Jung GPT has the potential to make mental health care more accessible and cheaper while also providing tailored support and advice. However, it is not intended to be a substitute for human therapists. Jung GPT is instructed to understand a wide range of concepts, including emojis, sensitive subjects, and various languages. Furthermore, participants were asked to fill out a survey based on their experience with Jung GPT. Additionally, analysis of the responses indicated that Jung GPT was helpful in identifying and exploring challenges, and the use of Jung GPT by participants in the future is highly possible. The results demonstrate that Jung GPT does help in recognizing challenges or problems within the users. On this basis, it is recommended that individuals use Jung GPT to explore their thoughts, feelings, and challenges. Moreover, further research is needed to better evaluate the effectiveness of Jung GPT.Keywords: Jung GPT, artificial intelligence, therapy, mental health, AI application
Procedia PDF Downloads 729053 Quoting Jobshops Due Dates Subject to Exogenous Factors in Developing Nations
Authors: Idris M. Olatunde, Kareem B.
Abstract:
In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops
Procedia PDF Downloads 4199052 Human Capital, Adversity Quotient and Entrepreneurial Success
Authors: Vichada Chokesikarin
Abstract:
We propose that the ability to create the business success requires Adversity Quotient (AQ) and Human Capital (HC). The aims of the present study are to investigate adversity quotient, human capital and entrepreneurial success of accommodation entrepreneurs in Pranakorn, Bangkok and to examine the relationship between AQ, HC and Entrepreneurial Success. The participants of this study were 112 entrepreneurs in accommodation business in the Khao San/Grand Palace, the location nearby demonstration area in 2014. Specifically, we focus on higher adversity which provides a measure of one’s perceived capacity to prevail in the face of adversity and the effects of human capital on success. Results indicated that there is significant relationship between human capital and entrepreneurial success, while adversity quotient was found to partially mediate the entrepreneurial success. Moreover, our findings showed that the human capital -experience and skills- are more important than adversity quotient. This suggests that the entrepreneurial success should rely on their skill and experiences.Keywords: accommodation business, adversity quotient, entrepreneurial success, human capital
Procedia PDF Downloads 3899051 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care
Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin
Abstract:
Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays
Procedia PDF Downloads 2209050 Characterization of Fine Particles Emitted by the Inland and Maritime Shipping
Authors: Malika Souada, Juanita Rausch, Benjamin Guinot, Christine Bugajny
Abstract:
The increase of global commerce and tourism makes the shipping sector an important contributor of atmospheric pollution. Both, airborne particles and gaseous pollutants have negative impact on health and climate. This is especially the case in port cities, due to the proximity of the exposed population to the shipping emissions in addition to other multiple sources of pollution linked to the surrounding urban activity. The objective of this study is to determine the concentrations of fine particles (immission), specifically PM2.5, PM1, PM0.3, BC and sulphates, in a context where maritime passenger traffic plays an important role (port area of Bordeaux centre). The methodology is based on high temporal resolution measurements of pollutants, correlated with meteorological and ship movements data. Particles and gaseous pollutants from seven maritime passenger ships were sampled and analysed during the docking, manoeuvring and berthing phases. The particle mass measurements were supplemented by measurements of the number concentration of ultrafine particles (<300 nm diameter). The different measurement points were chosen by taking into account the local meteorological conditions and by pre-modelling the dispersion of the smoke plumes. The results of the measurement campaign carried out during the summer of 2021 in the port of Bordeaux show that the detection of concentrations of particles emitted by ships proved to be punctual and stealthy. Punctual peaks of ultrafine particle concentration in number (P#/m3) and BC (ng/m3) were measured during the docking phases of the ships, but the concentrations returned to their background level within minutes. However, it appears that the influence of the docking phases does not significantly affect the air quality of Bordeaux centre in terms of mass concentration. Additionally, no clear differences in PM2.5 concentrations between the periods with and without ships at berth were observed. The urban background pollution seems to be mainly dominated by exhaust and non-exhaust road traffic emissions. However, temporal high-resolution measurements suggest a probable emission of gaseous precursors responsible for the formation of secondary aerosols related to the ship activities. This was evidenced by the high values of the PM1/BC and PN/BC ratios, tracers of non-primary particle formation, during periods of ship berthing vs. periods without ships at berth. The research findings from this study provide robust support for port area air quality assessment and source apportionment.Keywords: characterization, fine particulate matter, harbour air quality, shipping impacts
Procedia PDF Downloads 108